Variation in contraceptive prevalence rates in Tanzania: A multilevel analysis of individual and regional determinants.

OBJECTIVE: The aim of this study was to answer two key questions: (1) what are the individual and regional determinants of contraceptive use; and (2) what are the effect(s) of individual and regional variables on regional differences in contraceptive use? DATA AND METHOD: Multilevel logistic regression was applied on data from the Tanzania Demographic and Health Survey (TDHS) 2010 that allowed us to investigate simultaneously the individual and the regional determinants of contraceptive use and its regional variation. RESULTS: There was significant variation in contraceptive use, both between population groups as well as between regions. A higher number of children ever born, urban residence, and a non-manual occupation are characteristics associated with higher odds of a woman using contraceptives. Women who talk about family planning with community-based distribution workers and clinic staff also have higher odds of using contraceptives. The regional differences in the shares of women with a secondary education or above explain a significant portion of the regional variance in contraceptive use. Having secondary education and above is related to lower contraceptive use. CONCLUSION: This study constitutes a first step towards gaining a better understanding of the macro-level effects on decision-making processes regarding contraceptive use. The regional educational level explains a significant portion of the regional variance in contraceptive use. IMPLICATION STATEMENT: An advantage of our study over other studies in Tanzania is that we extended the determinants of contraceptive use to include not only individual-level factors, but also regional-level factors.